ClickCare Café

Do Hospitals Hide Data that Could Help with Care Coordination?

Posted by Lawrence Kerr on Thu, Apr 18, 2019 @ 06:00 AM

daan-stevens-282446-unsplashI’ve always said that it’s better to stay out of the hospital.

When confronted with risks of infection, error, or complications — it’s of course better to stay healthy and stay home.

But sometimes an elective surgery is wise or an emergency hospital stay is necessary. And in those cases, all of us want to be sure that our patients are safe.

But recent data and evidence has begged the question — are hospitals incentivized to hide infections when they occur?

I have to believe that almost all hospitals across the country prioritize patient well-being above any concerns about reputation or profitability.

But when antibiotic resistance combines with age-old concerns about infection and sickness in hospitals, things get serious. And even good intentions  for instance, to thoroughly investigate an outbreak without alarming people  can end up hiding data and information that could keep people safe. 

And the reality is that we all depend on hospitals sharing this information on their own behalf because there aren't agencies that will do so for them. In fact, as the New York Times reports, "under its agreement with states, the CDC is barred from publicly identifying hospitals that are battling to contain the spread of dangerous pathogens."  For instance in 2016, there was an outbreak of a drug-resistant pathogen in a Kentucky hospital  but it was not until 2018 that the CDC issued a report on the outbreak. And, of course, hospitals themselves have often "circled the wagons" when an outbreak occurs, looking into the infections themselves rather than sharing information more broadly. 

I completely understand wanting to limit public disclosure, especially in cases when public perception could be misinformed and reactive. Infection is complex and hospitals are often so big, they're like miniature cities, with outbreaks affecting a small minority of people.

But I do wonder whether the instinct to limit information about drug resistant infectious outbreaks within the medical community make sense. In fact, the tendency to limit information in this way is common in medicine, both at the level of the institution and at the level of the individual provider. We're under such immense pressure and scrutiny in the medical community  with such devastating consequences if mistakes are made  that many providers and organizations learn that it's better to keep information to yourself. The medical community often notices that "silos" keep excellent care, medical collaboration, and greater efficiency from happening  but the reality is that many of us have incentives to maintain those silos. So when an outbreak of an infection occurs, hospitals try to limit misinformation or panic  and in so doing, may limit information that could help other providers do care coordination or support them in solving the problem. 

I hope that hospitals are doing the best they possibly can to prevent outbreaks, as well as sharing information when the outbreaks occur. But I also know that all of us in medicine should learn to share information more freely, collaborate more effectively, and put our patients' care well above our own instinct to hide missteps or needs for support. And we hope that iClickCare can play a role in helping providers share information securely, safely, and without risking negative consequences. 

 

Try iClickCare for sharing information among the medical community members and within your medical team  safely and securely:  

Get Started

 

 

 

Tags: medical collaboration, care coordination

Care Coordination Failures Cause Long Term Care Transfer Issues

Posted by Lawrence Kerr on Thu, Apr 11, 2019 @ 06:00 AM

martha-dominguez-de-gouveia-572638-unsplashFor the older people at Long Term Care facilities, nursing homes, and assisted living facilities, even small issues — like a simple fall — end up with a transfer to the emergency room. Those visits to the ER can often mean a hospital stay as well. And of course, hospital stays can cause backtracking for overall strength, wellness, dementia, and disease. The best case scenario  a visit to a doctor instead of a visit to an ER  can still mean bouncing from provider to provider, with a lot of stress and physical challenges along the way. 

But aren't these ER visits, hospital stays, and doctors' visits simply the necessary realities of life. New insights and ways of working point to innovative solutions to this Business As Usual problem. 

There are 30,000 assisted living facilities in the US. As the New York Times reports, “most assisted living facilities have no doctors on site or on call; only about half have nurses on staff or on call.”

That means that if an event happens  a virus, a fall, a concern about a worsening condition  it results in a transfer, doctor's appointment, or ER visit, the vast majority of the time. Of course, coordination of medical transfers, tests, appointments, and the like can be a huge challenge for any person — but throw in significant physical challenges and perhaps cognitive impairment and the challenges compound.

“The assisted living industry has to recognize that the model of residents going out to see their own doctors hasn’t worked for a long time,” said Christopher Laxton, executive director of The Society for Post-Acute and Long-Term Care Medicine. “It’s an expensive, disruptive response to problems that often could be handled in the building, if health care professionals were more available to assess residents and provide treatment when needed.”

It's a way of caring for people that hurts the patient, the provider, the Long Term Care facility, and even the hospitals. Hospitals will stay away from sending their patients back to the community if they are afraid they’ll be readmitted within 30 days of discharge. And Long Term Care organizations may shy away from getting the right care for their residents if it often results in backsliding in their care. 

So what is the solution?

One solution has been to have a geriatrician on staff. But realistically, that doesn’t solve the problem. There will be myriad medical problems that fall outside of the expertise or time of that provider. 

There are two key things that need to happen:

  • Hospitals should partner with assisted living and nursing home facilities that have the means to do medical collaboration and prevent readmissions.
  • Long Term Care facilities must find ways to get the medical consults they need without putting their residents through the stress and danger of ER visits and bouncing among doctors’ appointments.

To facilitate those goals, though, hospitals, doctors, nurses, aides, and care providers at Long Term Care facilities need a platform to collaborate. The ideal scenario is that if a resident has a fall that isn't actually worrisome but could use "an extra pair of eyes,"  an aide can take a photo or video, consult with a trusted provider at a practice or hospital in the community, and keep the patient at home base until or unless a transfer is needed. It's good care in every way: it saves money, decreases readmissions, and ultimately supports the best possible health, wellness, and quality of life for the patient. It's a classic example, too, of why email or text messaging  in addition to not being HIPAA compliant  aren't nearly sufficient. In cases like this, whole teams are involved and cases need to by asynchronously collaborated on, over the span of time. A one-off question won't fit the bill. 

Care coordination and healthcare collaboration aren't a panacea. But I do believe that when it comes to Long Term Care, the impact of collaboration and coordination can be dramatic. 

 

If you're involved in Long Term Care, get our ebook on using telemedicine to improve care and make workflows more efficient:

 

Transforming Long Term Care Through Telemedicine

Tags: medical collaboration, long term care, healthcare collaboration, hippa secure healthcare collaboration

Medical Collaboration a Crucial Way to Prevent Malpractice Suits Involving Kids

Posted by Lawrence Kerr on Wed, Apr 03, 2019 @ 06:00 AM

alexander-dummer-261098-unsplashBy the end of their career, nearly half of all doctors will be sued.

Any suit is gut-wrenching for a doctor. It means that not only was there an undesired patient outcome, but the relationship with the patient has broken down to such an extent, that a lawsuit has become the chosen path forward.

That said, medical malpractice lawsuits involving children are especially disturbing and concerning. No doctor wants a child to have less than perfect care — and the litigation process itself can be deeply painful for all involved. So I was really interested to notice a recent study that seems to point to a commonsense way of decreasing your risk of being involved in a malpractice suit involving a child.


recent study, by The Doctors Company, looked at 1,215 malpractice claims filed on behalf of pediatric patients, from 2008 through 2017. These claims spanned 52 specialities and subspecialties.

What’s fascinating isn’t so much the claims themselves, but rather the root causes, allegations, and factors of the malpractice suits. Many of the most common factors in the lawsuits actually boil down to poor communication and poor medical collaboration among providers.

3 crucial highlights of the medical malpractice study that boil down to bad medical collaboration:

  • Missed, failed, or wrong diagnoses were the main reason for lawsuits.
  • Poor communication between the physician and the patient or family was a factor in up to 22% of claims, depending on the age of the child.
  • System and collaboration failures, such as not notifying treating physicians of critical test results, was also a primary cause of patient injuries. 

 

No doctor wants to put their patients at risk. And no doctor wants to be sued. But the sad truth is that many doctors think they're "too busy" for medical collaboration -- even though in all three of the determinants of medical malpractice above, medical collaboration could have been preventative. 

It's easy to say "an ounce of prevention is worth a pound of cure" for our patients. But the ounce of prevention created by medical collaboration is worth far more than trying to "cure" a bad outcome or lawsuit once it has already occurred. 

 

Learn more about how easy and fast medical collaboration can be:

ClickCare Quick Guide to Medical Collaboration

Tags: medical collaboration, hybrid store and forward medical collaboration, healthcare collaboration

Vaccines and Autism Fears Demonstrate Demands on Telemedicine

Posted by Lawrence Kerr on Thu, Mar 21, 2019 @ 06:00 AM

hyttalo-souza-1074680-unsplashFor many decades, we’ve thought about vaccines as a battle of science catching up with disease.

Conquering polio or measles was about finding the vaccine that would protect human bodies from those diseases, and then distributing those vaccines broadly enough to create immunity across the population.

However, there have been recent outbreaks of diseases that call into question this understanding. In places like the US and Europe, where the vaccines are established and the distribution is strong, we’ve seen a recent backsliding, with outbreaks of diseases like measles affecting communities. For instance, Washington State has had 71 cases of measles, just in the last few months.

So what are we to learn, as healthcare providers and leaders? And is there any way to win?

These outbreaks are of such concern, in fact, that there was a congressional hearing recently to explore the causes and potential fixes for these outbreaks.

Saad Omer, MBBS, MPH, PhD, from the Emory Vaccine Center, told the U.S. Senate Committee on Health, Education, Labor and Pensions that to battle new outbreaks, funding is needed not just for vaccines and research — but also for communication with the public about vaccines.

The biggest chink in the armor of our protection against these diseases is actually misinformation about vaccines, not limitations of the vaccines themselves. We all know about the concerns that boiled up in recent years about the supposed link between vaccines and autism. As Fierce Healthcare summarizes, “A paper published in The Lancet more than 20 years ago was long ago retracted after the author admitted to falsifying the information, but the concerns among many parents have persisted.”

This context shows clearly that in this case, protection against disease is about more than just science and treatment -- it's about the emotions, fears, and ideals of human beings. Whatever the science shows, if a mom believes the vaccine will cause autism, her child won't receive it. John Wiesman, DrPH, MPH, who is Washington's secretary of health said, “We need to be looking at how it is we get to the hearts and minds of people around vaccines and to not put science on the shelf."

 

 

Healthcare can't be distilled to a procedure, a recommendation, a scientific finding, or a single intervention. It's a messy, complex art that involves the hearts, minds, bodies, and social context. Which is exactly why healthcare collaboration can't just be secure text messages between two providers. It needs to allow the complex, long-term interactions of a whole medical team, across the continuum of care, and over time.

Hybrid store-and-forward telemedicine is a technology that supports this very human way of caring. And when the human context is respected -- it means that the science can succeed.

 

ClickCare Quick Guide to Hybrid Store-and-Forward

Tags: medical collaboration, hybrid store and forward medical collaboration, healthcare collaboration

Dramatic Videoconferencing Screw-Up Brings Up Telemedicine Questions

Posted by Lawrence Kerr on Wed, Mar 13, 2019 @ 06:00 AM

glenn-carstens-peters-210782-unsplashWe've all been blindsided by technology taking the place of a human, when and where it shouldn't. 

It's the labyrinthine customer service switchboard when we just want to ask a simple question of a real person. It's the app that sends us in circles when we really just want to pay a bill. 

But a recent technology screw-up touched a serious nerve for one family -- and even called into question whether and how telemedicine should be used. 

Mr. Ernest Quintana was in the hospital for the third time in 15 days, as the New York Times recently recounted. His lung cancer was beginning to get the best of him and he was struggling. His family remained hopeful, though, and they were all with him throughout the hospital stay. 

One afternoon, though, Mr. Quintana was surprised to find a machine with a video screen on it being wheeled into his room. With his granddaughter by his bedside, Mr. Quintana listened as a doctor in an undisclosed location, and whom he had never met, began to discuss his care. His surprise turned to sadness and dismay when the doctor shared that Mr. Quintana was likely not going to survive this hospital stay and prepared him for end-of-life care.

A prognosis of death is never easy news for a person or a family. But hearing the news from a doctor you have a relationship with, who brings compassion, presence, and leadership, can decrease the suffering and ease the way forward. In Mr. Quintana's case, the terrible news and challenging decisions were worsened by the impersonal and jarring way that they were broached. No one wants to have a conversation about death with a stranger on a video screen. 

So is this a condemnation of telemedicine? Of technology?

I don't think so. I believe that this sad turn of events simply points to positive and negative uses of telemedicine and positive and negative uses of technology. 

So many people default to videoconferencing as the go-to (or even default) form for telemedicine to take. We believe videoconferencing has severe limitations because it requires expensive hardware and circuitous scheduling coordination. Those are some of the reasons that we believe hybrid Store-and-Forward telemedicine is significantly more powerful of a tool.

But this story brings into focus an even more important and powerful reason that we believe telemedicine should be about team-based collaboration -- not videoconferencing between a doctor and a patient. When telemedicine is used for healthcare providers to collaborate among each other, the patient can interact primarily or exclusively with the providers that they have a relationship with -- and the "other opinions" on the team can be shared among the medical team. That way, the providers can be leaders, healers, and human beings FIRST -- but use telemedicine to consult with other people on the team as necessary, and without disruption to the care for that patient.

For instance, in Mr. Quintana's case, perhaps an outside opinion was necessary regarding his end-of-life care. But rather than that opinion being piped in through a video screen, we believe it would have been far better for his provider, obviously, to consult with the outside doctor -- and then have a conversation with Mr. Quintana in person, within the context of their existing relationship. 

Don't risk this kind of technology screw-up. Prioritize human relationships and let technology -- and telemedicine -- serve them. 

 

ClickCare Quick Guide to Hybrid Store-and-Forward

 

 

Tags: medical collaboration, hybrid store and forward medical collaboration, healthcare collaboration

Healthcare Travel and Wait Times Are Bad - But is That Our Problem?

Posted by Lawrence Kerr on Wed, Mar 06, 2019 @ 06:00 AM

andrik-langfield-266832-unsplashMy daughter recently signed her new baby up as a patient at a pediatric practice and had to choose one of the doctors in the group. “Dr. Salno,” they said, “is great. But you have to wait at least an hour to see him, every time.” She ended up choosing another doctor in the practice.

Her experience isn’t uncommon — so many of the very best healthcare providers we know have long wait times in their offices or are frequently running behind. Is that a problem for healthcare, or is it simply part of the reality?

 

In our experiences as medical providers, there is sometimes a sense that long wait times, doctors who are hours behind, and extensive travel to get medical care are all just facts of life in medicine. And that makes sense — there is a shortage of providers, especially physicians, and every healthcare provider I know has far more work to do each day than time to do it in. For some of us, long wait times and long travel times are practically badges of honor, showing just how in demand our practice is. 

In fact, those travel and wait times are long, and aren't decreasing. A recent study by Altarum shows that “Despite significant investments in the United States [from 2006 to 2017] in improving access to health care through better insurance, the use of innovative delivery systems, and advances in digitizing health care records and automating administrative processes, travel and wait times show no discernable improvements.”  These dynamics haven't been improving in decades.

The place that I see travel times really come into play are for patients with complex, chronic, or even acute but serious conditions. According to the Altarum study, patients who reported their health as “poor”, spent an average 26.4 hours per month on healthcare. That time may be transiting from provider to provider, from appointment to appointment, in addition to actually accessing care. 

But is this time that patients spend a bad thing? Is it something that should be decreased? And further, are travel and wait times something that healthcare providers should concern themselves with, or is it someone else’s problem?

Long travel times may not seem like the healthcare provider's problem until we consider the health cost of that time. Of course, there is the element of lost productivity and wages. But even just focusing on health itself, I believe that spending so much time accessing healthcare, as well as transit and waiting, has a severe and negative impact on our patients' health. Time spent at home with loved ones, hours invested in hobbies, focus at work, and rest in our own beds are all crucial elements of healing from disease. Every hour that a patient spends in a waiting room or driving to yet another appointment detracts from this healing time. 

So what can healthcare providers do? Most importantly, we can try to understand our patients' lives, travel times, wait times, and recovery and see it as "our problem." We can use medical collaboration tools to loop in other providers' input without the patient needing to trek across the state to gain that input when a picture and a discussion is actually all that is required (and this is reimbursable). When tools like iClickCare exist, that use telemedicine to dramatically decrease transit and wait times, there is the opportunity for health to truly improve, because the patients are able to spend more time healing and less time transporting or waiting 

 

ClickCare Quick Guide to Hybrid Store-and-Forward

 

Tags: hybrid store and forward medical collaboration, healthcare collaboration, medical collaboration tool

Why $5 of Supplies Can Prevent Thousands of Deaths

Posted by Lawrence Kerr on Thu, Feb 28, 2019 @ 06:00 AM

phuong-tran-1248347-unsplashIf there is one thing we all agree on, it’s that healthcare is complex.

The health of any individual is, of course, complex — with thousands of variables in the matrix of health, illness, and healing. Further, healthcare itself is complex, with so many challenges and opportunities that it’s easy to lose hope that things can change or improve.

So it’s deeply heartening when we stumble across a healthcare initiative that is outrageously simple, but with profound results.

Recently, I stumbled across two healthcare interventions that are deeply effective but very, very simple.

First, a group of California hospitals implemented a simple post-hospital educational initiative to reduce MRSA infections. 2000 patients were given either education on preventing infections via hygiene or that education plus antiseptic for bathing, antiseptic mouthwash, and antibiotic nasal ointment. The results? MRSA infections came down by 30%, with the education-plus-supplies group showing the most improvement. No new technologies were pioneered; nothing expensive was implemented. Just a simple “care package” to send home with patients from the hospital.

Second, a Virginia VA hospital had its nurses spend extra minutes with patients plus spend $5 on a toothbrush and toothpaste to encourage patients to brush their teeth. The results? Non-ventilator cases of hospital-acquired pneumonia have decreased by 90%. So far, they estimate that they’ve saved 21 lives and reduced costs by $4.69 million. Pretty phenomenal results for something as simple as a toothbrush and a helping hand.

So is there anything that we can conclude from these two studies, other than celebrate the ingenuity of their pioneers? I think there is. 

2 Key Learnings From These Pioneering (But Simple!) Studies: 

  • Simple and inexpensive can be best. 
    One thing that we love about iClickCare is that it's a simple, inexpensive way to do telemedicine -- no expensive new hardware or computers or huge software implementations required. Sadly, some in healthcare believe that complexity is always better -- so they'd almost prefer a more expensive, more difficult product. But these studies are yet another proof point of how misguided that approach is. 
  • Real life trumps theory. 
    In both of these studies, the initiatives were thoughtful about the reality that patients would face as people receiving care (one in the hospital, and one after the hospital stay.) It's easy for us in healthcare to focus on the glamorous treatment -- like a sophisticated surgery -- and forget that something as simple as nasal ointment or tooth-brushing can save lives. Similarly, we believe it's crucial to collaborate across the continuum of care -- not just between specialists -- since often, aides or nurses or others on the team will have a more "real life" perspective that can help.

The bottom line? Don't be afraid to do what is right for your patients, even if it doesn't sound fancy. It's possible that the deeply un-fancy is what's going to save healthcare -- and save lives. 

 

For more stories of smart collaboration, download our Quick Guide:

ClickCare Quick Guide to Medical Collaboration

 

 

Tags: telehealth, healthcare collaboration

Why Robots May Not Steal Your Job as a Medical Provider

Posted by Lawrence Kerr on Tue, Feb 26, 2019 @ 06:00 AM

franck-v-740555-unsplashIn a conversation with a young doctor recently, she sighed as she considered her future as a physician.

“I just don’t think my job is going to really exist in a decade or two,” she said. “It’s all going to be computers and nurse physician assistants.”

It’s a scary thought — that doctors as we know them  won’t have a role in providing medical care in the future. But is it true?

 

The applications to the U.S. Patent and Trademark Office are always illuminating as to what is on the horizon in the world of science and technology. Patents reflect those innovations that may or may not have a business plan or a market, but often reflect the direction that technology is headed more generally.

So I was interested to note that Google is developing an electronic health record (EHR) that uses machine learning to predict clinical outcomes.

As Fierce Healthcare reports, “Google appears to have plans to develop its own electronic health record (EHR) for clinicians that gathers patients’ medical records and then leverages machine learning to predict clinical outcomes, according to a patent application."

So is this patent application, backed by tech's behemoth, a harbinger of the inevitable phase-out of doctors?

I don't think so. True enough: it’s almost certain that the role of computers in our practice of medicine will continue to increase. But the truth is that doctors' core role is so much more essential and irreplaceable than any diagnosis, computer-assisted or otherwise. Ultimately, physicians are healers. And a computer can diagnose. A computer can perhaps even treat. But it takes a human being to truly heal another. 

That said, I believe that for medicine to be truly resilient -- for healthcare providers to continue to be relevant into the future, we need to lean into the art and humanity of medicine. The trend over the last couple of decades has been to reward providers who treat medicine like a complex factory -- the more efficiently and flawlessly you can move through the heap of patients, the more you are rewarded. But I believe that we are beginning to experience a shift. And into the future, simply being efficient and precise is not going to be our path forward. 

I believe that medical collaboration with our very human colleagues is a crucial part of leaning into that art and humanity. It's a tool that we can use to treat the whole patient, and do so with true thought. Our practice will likely be assisted by machine learning and artificial intelligence in the future. But if we're doing our jobs right, that assistance simply can't replace us. 

Get Started

Tags: telehealth, medical collaboration tool

Why Opioid Overdoses Spotlight Care Coordination Failures

Posted by Lawrence Kerr on Thu, Feb 21, 2019 @ 06:00 AM

tom-parsons-426898-unsplashThe US opioid epidemic is reaching unprecedented levels. Almost 48,000 people died of an overdose in 2017 and millions of people are affected by opioid abuse. 

One challenge in the treatment of opioid abuse and overdose is that they lie at the intersection of multiple disciplines, providers, and dynamics. Mental health, public policy, law enforcement, social work, housing, emergency care, and medication all play a role. But too often, only the immediate problem is addressed -- and care coordination fails -- which means that patients end up experiencing chronic repetition of that problem. 

A recent study looks at why opioid overdoses reveal the significant cracks in the care coordination that exist -- and endanger all patients.

You could say that West Virginia is Ground Zero for the opioid epidemic. The state has an opioid overdose rate more than three times the national average and the highest death rate from drug overdoses in the country. So the challenges that patients and providers face there are instructive for providers in states with less severely affected populations but who face similar dynamics.

In an effort to understand the trajectory of care for these patients, Fierce HealthCare looked at a recent West Virginia study of Medicaid claims. Researchers followed the treatment of patients after the overdose code to see whether follow-up care was billed. For instance, checking to see whether mental health visits, opioid counseling visits or prescriptions for psychiatric and substance abuse medications were billed after the initial Emergency Room care. 

Following ER care for an overdose, less than 10% of patients received a substance abuse drug and fewer than 15% received mental health counseling. Of course, it’s possible that the rate of referrals was higher and that many patients didn’t access the counseling. But realistically, follow-up may be as crucial a part of the care as the initial care itself. As one patient who was treated for an overdoes in the ER said, “There were a lot of times I could have gone down a better path, and I fell through the cracks."

I noticed several key insights from this study that I think are meaningful for any provider, regardless of how relevant opioid abuse in particular feels to them. 

4 key learnings from opioid overdose and care coordination failures:

  • The more complex the disease, the greater the risks for coordination.
    But "complexity" doesn't just come from the details of the disease itself. In opioid abuse, multiple parties, including healthcare providers and social services all need to come together to care for the patient effectively. And these providers must collaborate across institutional lines, across the continuum of care, and across a long time horizon. This complexity is where we start to see care coordination fall apart -- but really it just reveals the weakness in care coordination that exists for all patients.
  • Some diseases are associated with less sympathy than others. 
    The reality is that with drug overdoses, there may be an aspect of moral condemnation in the ways that healthcare approaches the problem. As healthcare providers, we know that opioid abuse is really a complex disease. But it's very possible that bias sneaks in and the complex coordination of providers, services, and care falls short because providers may feel less sympathetic about the particular aspects of this disease. Some of our most vulnerable populations may have healthcare challenges that are frustrating or overwhelming to providers -- and it's important that providers are able to collaborate with social services and colleagues that can support these patients in ensuring appropriate care.
  • All good care goes beyond acute care. 
    It’s never enough to simply treat the acute illness that is right in front of us. But as providers, we need the tools and collaboration to care for patients more broadly than that. Most emergencies require more than simply treating the situation in front of us. A baby's stitches in the ER require follow-up with the pediatrician. An overdose necessitates counseling and substance abuse drugs.

Our EHRs and systems simply don't support this more broad understanding of what it means to provide care in complex situations. And that means our patients are receiving subpar care, due to the limitations of our tools and workflows. Each healthcare provider is doing his or her job to the best of his or her ability. But the demands of caring for our patients mean that sometimes just "doing our job" isn't good enough -- we must also look at the big picture of that care. And we must demand tools to help us act well and care appropriately within that big picture. 

 

You can try iClickCare for free, and get started in one day. Sign up for free here:

Get Started

 

 

Tags: care coordination, healthcare collaboration

The 3 EMR Interoperability Blindspots Your Hospital Has

Posted by Lawrence Kerr on Thu, Feb 14, 2019 @ 06:00 AM

rawpixel-782046-unsplashRecently, seven major hospital systems put out a bold call.

It is crucial, they contend, to improve data sharing and interoperability among EMRs and EHRs. As Fierce Healthcare reports, "In a 2017 AHA survey, 57% of respondents had experienced challenges sending the proper information to a different vendor platform. And 37% ran into challenges just matching patient identities between systems."

Any healthcare provider who works with Electronic Medical Records won't dispute that data sharing is lacking with these tools. But despite the importance of this report, I see 3 crucial blindspots that it has -- and that your hospital may have, too.

I agree that interoperability among EMRs and EHRs is something that we should all demand. The simple access to data about your patient is as fundamental as having a clean and private exam room to see that patient in... or as having the ability to record your own notes about that patient. 

So I was glad to see this hospital report come out. That said, I believe there are three crucial shortcomings to this report. And identifying them isn't so much to undermine the findings or importance of the report itself -- but to identify blindspots that your hospital may have as it begins to pursue interoperability of EMRs and EHRs.

 

3 crucial shortcomings to focusing on EMR interoperability:

  • EMRs / EHRs will never be true healthcare collaboration tools.
    No matter how sophisticated interoperability among medical records becomes, the truth is that these systems will never be true healthcare collaboration tools. The records simply aren't made to easily facilitate multidirectional care coordination and medical collaboration among all members of a care team. And so it's a mistake to believe that by solving interoperability, we might have improved care coordination or collaboration. 
  • Providers need better tools now. 
    The reality is that even if EMRs and EHRs become more interoperable, healthcare providers need better communication and collaboration in the meantime. The reality is that today, EMRs and EHRs consistently get in the way of sharing data and patient information. Until the day that EMRs/EHRs are interoperable, healthcare providers must take the burden on themselves of making sure that other members of the care team have HIPPA-secure access to patient information. 
  • We need collaboration among people, not computers. 
    The AHA report emphasized that "there is an urgent need to coalesce around improved standards that overcome the significant gaps making communication difficult between systems." In other words: we need our computers to communicate better. But the harder truth is that allowing computer systems to share data is just Step One. What is really needed in medicine is the ability of providers to collaborate and coordinate care. The data-sharing is just the foundation -- it doesn't necessarily facilitate the profound collaboration that needs to occur for good care to happen. 

As always, these organization-level initiatives -- like those to improve interoperability -- are crucial. They are long-term projects that affect key foundational aspects of what we do as providers. But these projects are often uni-dimensional and may not affect our work in the holistic ways we need them to. So even as hospital-level and nation-level work occurs, we as providers must create and demand tools that are immediate and holistic enough to support excellent care for our patients. 

 

ClickCare Quick Guide to Medical Collaboration

 

 

Tags: care coordination, EHR, EMR, medical collaboration tool

Subscribe By Email

Recent Posts

Posts by Topic

see all